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Updated: May 23, 2026
Thermal Ablation for the Treatment of Abdominal Tumors
Published on: March 7, 2011
The role of pathology in small renal mass laparoscopic cryoablation
B W Lagerveld1, H van Dekken, G J L H van Leenders
1Department of Urology, St. Lucas Andreas Hospital, 1006 AE Amsterdam, The Netherlands.
Abstract:
Objective. We evaluated histological outcome of intraoperative biopsies at laparoscopic renal mass cryoablation (LCA), prevalence of peritumoral fat tissue invasion, and risk of tract seeding. Methods. Patients were biopsied 3-5 times (16-gauge). Histology was analyzed by general pathologists and reviewed. Peritumoral fat was histologically examined. The trocar used for biopsy-guidance was examined by cytology. Records were studied for reporting tract metastasis. Results. 77 biopsied renal masses with mean ± SD diameter 30 ± 7.4 mm were histologically classified by primary and review pathology revealing 64 and 62 malignancies, 13 and 15 benign lesions, respectively. In 30/34, the fat covered a carcinoma but revealed no malignancy. Cytology showed no malignant cells but was inconclusive in 1 case. No tract metastasis occurred. Conclusions. The use of an intraoperative biopsy protocol provides histological diagnosis of all renal masses. No existence of peritumoral fat tissue invasion or tract seeding was found.
Insights
Intraoperative biopsies during laparoscopic renal mass cryoablation (LCA) accurately diagnose tumors. This study found no evidence of peritumoral fat invasion or tumor seeding along biopsy tracts, ensuring patient safety.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Laparoscopic renal mass cryoablation (LCA) is a minimally invasive treatment for kidney tumors.
- Accurate pre-operative diagnosis is crucial for effective treatment planning.
- Intraoperative biopsies can provide immediate histological information.
Purpose of the Study:
- To evaluate the histological accuracy of intraoperative biopsies in LCA.
- To determine the prevalence of peritumoral fat tissue invasion.
- To assess the risk of tract seeding after biopsy and LCA.
Main Methods:
- 77 patients with renal masses underwent 3-5 intraoperative biopsies using a 16-gauge needle.
- Histological analysis was performed by general pathologists and reviewed.
- Peritumoral fat and biopsy trocar sites were examined for malignancy and seeding.
Main Results:
- Histological classification revealed 64/62 malignancies and 13/15 benign lesions (primary/review).
- Peritumoral fat invasion was not detected in any malignant cases examined.
- No malignant cells were found on trocar cytology, and no tract metastasis occurred.
Conclusions:
- Intraoperative biopsy protocols are effective for diagnosing renal masses during LCA.
- Peritumoral fat invasion and tract seeding are not significant risks associated with this procedure.
